Ye Hua, Zhao Chengguang, Yang Lehe, Yu Wenwen, Leng Zhefeng, Sun Yangjie, Xiao Zhongxiang, Zhang Xie, Zheng Long, Ye Xinxin, Zheng Legui, Huang Xiaoying, Dai Yuanrong, Li Jifa
Department of Respiratory and Critical Care Medicine of Affiliated Yueqing Hospital, Wenzhou Medical University, Wenzhou 325600, Zhejiang, China.
Department of Respiratory and Critical Care Medicine of the First Affiliated Hospital, Wenzhou Medical University, Wenzhou 325000,, Zhejiang China.
EClinicalMedicine. 2020 Sep;26:100492. doi: 10.1016/j.eclinm.2020.100492. Epub 2020 Aug 24.
It has been reported that a fraction of recovered coronavirus disease 2019(COVID-19) patients have retested positive for SARS-CoV-2. Clinical characteristics and risk factors for retesting positive have not been studied extensively.
In this retrospective, single-center cohort study, we included adult patients (≥ 18 years old) diagnosed as COVID-19 in Affiliated Yueqing Hospital, Wenzhou Medical University, Zhejiang, China. All the patients were discharged before March 31, 2020, and were re-tested for SARS-CoV-2 RNA by real-time reverse-transcriptase polymerase-chain-reaction (RT-PCR) after meeting the discharge criteria. We retrospectively analyzed this cohort of 117 discharged patients and analyzed the differences between retest positive and negative patients in terms of demographics, clinical characteristics, laboratory findings, chest computed tomography (CT) features and treatment procedures.
Compared with the negative group, the positive group had a higher proportion of patients with comorbidities (Odds Ratio(OR) =2·12, 95% Confidence Interval(CI) 0·48-9·46; = 0·029), longer hospital stay (OR=1·21, 95% CI 1·07-1·36; = 0·008), a higher proportion of patients with lymphocytopenia ( = 0·036), a higher proportion of antibiotics treatment ( = 0·008) and glucocorticoids treatment ( = 0·003). Multivariable regression showed increasing odds of positive SARS-CoV-2 retest after discharge associated with longer hospital stay (OR=1·22, 95% CI 1·08-1·38; = 0·001), and lymphocytopenia (OR=7·74, 95% CI 1·70-35·21; = 0·008) on admission.
Patients with COVID-19 who met discharge criteria could still test positive for SARS-CoV-2 RNA. Longer hospital stay and lymphopenia could be potential risk factors for positive SARS-CoV-2 retest in COVID-19 patients after hospital discharge.
Natural Science Foundation of Zhejiang Province, Medical Scientific Research Fund of Zhejiang Province, Wenzhou science and technology project.
据报道，一部分康复的2019冠状病毒病（COVID-19）患者再次检测出严重急性呼吸综合征冠状病毒2（SARS-CoV-2）呈阳性。再次检测呈阳性的临床特征和危险因素尚未得到广泛研究。
在这项回顾性单中心队列研究中，我们纳入了在中国浙江省温州医科大学附属乐清医院被诊断为COVID-19的成年患者（≥18岁）。所有患者均于2020年3月31日前出院，并在符合出院标准后通过实时逆转录聚合酶链反应（RT-PCR）对SARS-CoV-2 RNA进行重新检测。我们对这117名出院患者的队列进行了回顾性分析，并分析了重新检测呈阳性和阴性患者在人口统计学、临床特征、实验室检查结果、胸部计算机断层扫描（CT）特征和治疗过程方面的差异。
与阴性组相比，阳性组合并症患者比例更高（优势比[OR]=2.12，95%置信区间[CI]0.48-9.46；P=0.029），住院时间更长（OR=1.21，95%CI 1.07-1.36；P=0.008），淋巴细胞减少症患者比例更高（P=0.036），抗生素治疗比例更高（P=0.008）和糖皮质激素治疗比例更高（P=0.003）。多变量回归显示，出院后SARS-CoV-2重新检测呈阳性的几率增加与住院时间延长（OR=1.22，95%CI 1.08-1.38；P=0.001）以及入院时淋巴细胞减少症（OR=7.74，95%CI 1.70-35.21；P=0.008）有关。
符合出院标准的COVID-19患者SARS-CoV-2 RNA仍可能检测呈阳性。住院时间延长和淋巴细胞减少可能是COVID-19患者出院后SARS-CoV-2重新检测呈阳性的潜在危险因素。
浙江省自然科学基金、浙江省医学科研基金、温州市科技项目。
